Rückkehr in das Erwerbsleben nach kurativer Therapie von Kopf-Hals-Karzinomen

Zusammenfassung

Hintergrund Die Reintegration von Tumorpatienten in die Erwerbsfähigkeit ist ein bedeutender sozialer und ökonomischer Faktor. Für maligne Kopf-Hals-Tumoren (KHT) sind hierzu, verglichen mit anderen Tumorentitäten, bislang wenige Daten zusammengetragen und veröffentlicht worden.

Material und Methoden In einer selektiven Literaturrecherche wurden Originalarbeiten zwischen 1997 und 2018 zum Thema „Rückkehr in das Erwerbsleben nach Therapie von Kopf-Hals-Karzinomen“ eingeschlossen und analysiert.

Ergebnisse Es konnten 18 Originalarbeiten zum Thema berufliche Reintegration nach KHT identifiziert werden. Posttherapeutisch scheiden 10–52 % der vormals berufstätigen Patienten aus dem Berufsleben aus. Hinsichtlich der Tumorlokalisation, der Therapiemodalität und des Geschlechts als Prädiktoren der Rückkehr ins Erwerbsleben zeigte sich in den Studien ein inhomogenes Bild. Es scheinen Alter, sozioökonomischer Status, therapiebedingte Einschränkungen (z. B. Fatigue, Depression) und Nebenerkrankungen einen signifikanten Einfluss auf die berufliche Wiedereingliederung zu haben. Rehabilitationsmaßnahmen bewirken positive Effekte.

Schlussfolgerungen Patienten mit KHT haben ein hohes Risiko aus dem Berufsleben auszuscheiden. Die wenigen bisher zum Thema publizierten Studien sind wegen heterogener Methodik, den uneinheitlichen Messzeitpunkten und inhomogener Verteilung untersuchter Tumorlokalisationen nur schwer miteinander vergleichbar. Es zeigt sich weiterhin ein unzureichend adressierter Forschungsbedarf, um evidenzbasierte Konzepte zur Förderung der beruflichen Rehabilitation von KHT-Patienten entwickeln zu können

Abstract

Objective Reintegration of cancer patients into occupational life is an important social and economic factor. Data for the “return to work” in Head and Neck Cancer (HNC) patients are sparse, especially compared with other tumor entities.

Material and Methods In a selective literature research, original articles dealing with the theme complex “return to work in patients with HNC”, between 1997 and 2018 were included and analyzed.

Results 18 relevant articles were identified. After curative therapy, 10–52 % of previously employed patients retired from their work. The influence of the predictors tumor localization, therapy modality and gender were not consistent. However, age, socioeconomic status, therapy-related impairment (e. g. fatigue, depression) and co-morbidity were significant factors for return to work. Rehabilitation exerts a positive effect.

Conclusions HNC patients have a high risk to retire from work. The heterogenous methods, the non-standardized points in time used for the assessments and inhomogeneous distribution in tumor localization make it difficult to compare these studies. There is an unmet need of further research in HNC patients to develop evidence-based concepts to facilitate their return to work.

Schlüsselwörter

Rehabilitation - Kopf-Hals-Karzinom - berufliche Wiedereingliederung - Erwerbsfähigkeit - Oropharynxkarzinom - Larynxkarzinom - sozioökonomischer Status

Key words

head and neck cancer - employment - return to work - rehabilitation - occupational status

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